CalMHSA Suicide Prevention Social Marketing Project .
CalMHSA Suicide Prevention Social Marketing ProjectBaseline Media AnalysisWRITTEN BYTheresa LyAnara GuardSandra BlackEducation Development Center, Inc.August 2012
Media AnalysisTable of ContentsExecutive Summary3Introduction4Past Studies Analyzing Adherence to Established Recommendations5The California Study on Media Adherence to National Consensus Recommendations forReporting on Suicide Methods Areas of Analysis Findings Coverage type Suicide prevention resources Information on “how to help” Information about warning signs and risk factors for suicide Single condition or event prior to suicide Suicide method Persons quoted Contents of suicide notes Language used to describe suicide Sensational language about numbers and rates of suicide Visuals Discussion Conclusion Study Limitations Next Steps References Figure 1: Newspapers in Final Sample Figure 2: Television Stations in Final Sample Figure 3: Designated Market Areas (DMAs) and Counties Covered within Each DMA57891315161921222425262627292930303132332 Page
Media AnalysisExecutive SummaryAppropriate reporting on suicide can relay accurate facts, raise awareness about thepreventability of suicide and educate the public on resources and treatment options. Whensuicides are not reported on appropriately, the media can also indirectly transmit suicidecontagion—the process by which one suicide becomes a compelling model for successivesuicides. Efforts to reduce contagion led to the development of a national consensus TheRecommendations for Reporting on Suicide (“the Recommendations”) for reporting on suicide.The California Suicide Prevention Social Marketing Project, funded by the voter-approvedMental Health Services Act (MHSA) (Prop. 63), aims to improve reporting on suicide throughtraining individuals in counties on media outreach, providing counties with a guide to mediaadvocacy, conducting forums with journalists and other stakeholders and disseminating theRecommendations to news media throughout the state. It is overseen by the California MentalHealth Services Authority (CalMHSA), an organization of county governments working toimprove mental health outcomes for individuals, families and communities. To measure howeffective these interventions will be, the project conducted the nation’s first study to examinehow well news media currently adhere to the Recommendations. The authors created a uniquetool to measure California media outlets’ adherence and applied it to a sample of more than 200recent reports to establish a baseline measure.The following pages report on the findings in 12 areas: coverage type; resources; how to help;warning signs and risk factors; attributing suicide to a single condition; reporting on location;reporting on method; sources of quotes; content of suicide notes; language used; reporting onnumbers and rates; and visuals.The results of this study show that California newspaper and television coverage of suicideduring the last six months of 2011 did not consistently adhere to the Recommendations forReporting on Suicide. Although sensational reporting was not the usual practice, it wasdetermined that much more could be done to promote the concepts of preventability, inform thepublic about available resources and reduce graphic coverage.California news media showed the strongest degree of adherence to the Recommendations inplaces where they discourage certain reporting practices, such as providing details aboutmethod, or using sensational language. Very few articles or broadcasts sensationalized suicide orprovided overly graphic descriptions of method. The Recommendations discourage thesepractices because they can increase the risk for contagion and they provide misinformationabout suicide to the community.The lowest degree of adherence to the Recommendations was in areas that encourage providinghelpful resources and interviewing suicide prevention and mental health professionals asreliable sources of information. The Recommendations call for these practices because theyfurther the message of the preventability of suicide and make the community aware of resourcesthat provide help. Much more can be done to routinely provide crisis telephone numbers whenreporting on suicide and to cover prevention programs and activities.An analysis of California coverage will be repeated in 2014 to examine reporting during the lastsix months of 2013 and any changes that may result from these interventions.3 Page
Media AnalysisIntroductionThe news media—journalists, editors and producers who report news via newspapers, radio,television and the internet—can have a powerful influence on how the public perceives suicide.Appropriate reporting on suicide can relay accurate facts, raise awareness about thepreventability of suicide and educate the public on resources and treatment options. Whensuicides are not reported on appropriately, the media can also indirectly transmit suicidecontagion, which is the process by which one suicide becomes a compelling model for successivesuicides (Gould, 2001). Research has shown that extensive newspaper coverage of suicide isassociated with a significant increase in the rate of suicide. The magnitude of the increase isproportional to the amount, duration and prominence of the media coverage (Gould, 2001).Efforts to reduce contagion led to the development of a national consensus recommendationsfor reporting on suicide.1 The Recommendations for Reporting on Suicide (“theRecommendations”) provides suggestions to the news media on how best to address suicide.According to the recommendations, covering suicide carefully, even briefly, can change publicmisperceptions and correct myths, which can encourage those who are vulnerable or at risk toseek help. For more information on the Recommendations, visit www.reportingonsuicide.org.The California Suicide Prevention Social Marketing Project2 aims to improve reporting onsuicide through several interventions—training individuals in counties on how to do mediaoutreach, providing counties with a guide to media outreach, conducting forums with journalistsand other stakeholders and disseminating the Recommendations to news media throughout thestate. To measure how effective these interventions will be, the project conducted the first studyin the nation to examine how well news media currently adhere to the Recommendations. Theauthors created a unique tool to measure California media outlets’ adherence to theRecommendations and applied it to a sample of more than 200 recent reports in order toestablish a baseline measure.The first set of recommendations was created by Centers for Disease Control (CDC) in response toreporting on a cluster of suicides that occurred in New Jersey in 1987. In 2001, new recommendationswere created by a group of two national suicide prevention organizations, four federal agencies and ajournalism think tank. The Suicide Prevention Resource Center created a brief “at-a-glance” version ofthese recommendations in 2005. The current set of recommendations for reporting on suicide, released in2011, was agreed on by 50 suicide prevention experts, advocacy groups, research institutions and mediaorganizations, making them consensus recommendations. The recommendations are also grounded inresearch that demonstrates how certain depictions of suicide can lead to contagion.1The California Suicide Prevention Social Marketing Project is part of the broader California SuicidePrevention Initiative, funded by the California Mental Health Service Authority (CalMHSA). This Projectis being implemented by staff from AdEase, the Education Development Center and Your Social Marketer.24 Page
Media AnalysisPast Studies Analyzing Adherence to Established RecommendationsA handful of studies have been published that examine the media’s adherence to establishedrecommendations for reporting on suicide. The following summarizes findings from some paststudies.The first study to analyze adherence to established reporting recommendations (Jamieson, etal., 2003) reviewed three years (1990, 1995, and 1999) of suicide articles (n 279) published inThe New York Times, and measured their adherence to the 1994 CDC Media Guidelines. Theanalysis determined that the articles did not focus on the link between diagnosable mentaldisorders and suicide but on a single precursor to the suicide, such as a negative life event. Theauthors concluded that readers were unlikely to learn much about the likely cause of suicide orto understand the importance of seeking treatment for mental disorders that are known toincrease the risk of suicide.Another study looked at the adherence of five major Hong Kong newspapers to the 2000 WorldHealth Organization (WHO) media guidelines (Fu & Yip, 2008). This study examined 5,740articles to analyze how papers reported on suicide before and after the implementation of anawareness campaign about the WHO guidelines. Prior to the campaign, the majority of newsarticles about suicide were accompanied by a photograph, mentioned the suicide method in theheadline and described the circumstances surrounding the method in the headline. Followingthe campaign, there were significant decreases in the pictorial presentation of suicide and in thenumber of news articles with headlines describing the circumstances surrounding the suicide.Tatum et al. (2010) conducted a national study that looked at 968 suicide articles published inselect daily regional and national newspapers between 2002 and 2003 to determine adherenceto the 2001 recommendations. The study found that coverage did not consistently reflect themedia guidelines. Suicide stories often detailed the method and location while rarely providinginformation about warning signs and risk factors, the influence of mental disorders andsubstance abuse, and the availability of prevention resources.Each of these studies was limited in that they were 1) cross-sectional with no follow-up analyses;2) based solely on newspaper articles; and 3) not based on the results of an intervention tochange how the media reports on suicide. In addition, no existing study has examinedadherence to the most recent version of the Recommendations.The California Study on Media Adherence to National ConsensusRecommendations for Reporting on SuicideMethodsRetrieving print media sampleThe project staff used Lexis-Nexis (www.nexis.com) to search for relevant articles published inCalifornia-based newspapers from July 1 to December 31, 2011. Weekly newspapers, businesspapers and newspapers published in languages other than English were excluded. A total of 57newspaper sources were available using these search criteria. The search terms used included“suicide” and “killed self”. Use of the term metaphorically, such as “political suicide” or“economic suicide” was excluded for the search. Obituaries and op-eds were excluded from thefinal sample as were articles that were a) fewer than 50 words; b) exact duplicates of other news5 Page
Media Analysisarticles; c) discussed suicide only in passing; or d) deaths that had not yet been ruled a suicide. Afinal sample of 228 news articles from 28 California newspapers was collected.Retrieving television broadcast media sampleThe project staff used Vocus (www.vocus.com) to search for relevant news broadcastsoriginating from California-based television stations. The broadcasts were gathered from thefirst two weeks of each month, July through December, 2011. The search term used was“suicide” with the same exclusions of metaphorical usage. Transcripts were obtained for 64broadcast stories from 17 California broadcast stations using these search criteria. (Archivedradio broadcasts were not available through Vocus.)Homicide-suicideHomicide-suicides constituted more than one-third of the final article and broadcast sample.The national estimate of homicide-suicide is very low compared to suicide estimates. TheViolence Policy Center estimated that about 1,380 homicide-suicides occurred across thecountry in 2011. In comparison, the Centers for Disease Control and Prevention indicate nearly37,000 suicides occurred in 2009 (most recent national data available). The over-representationof homicide-suicides in the news sample indicates that these events are noteworthy. Inreviewing the sample, project staff observed that homicide-suicide news stories tended to bemore graphic than suicide-only reports, never provided suicide prevention resources, and oftenimplied that the deaths were triggered by a single event or cause. However, theRecommendations do not provide guidance on how to cover homicide-suicides, and thereforethese stories were excluded from the analysis.Final sampleThe final sample for analysis consisted of 161 newspaper articles and 47 televisionbroadcasts. A subset of 19 television news segments was purchased to conduct a thoroughvisuals analysis. The remaining 28 broadcasts were analyzed by reading the transcripts.Newspaper articles were read in full text. This analysis describes the findings for newspaperarticles, television broadcasts and “news items” (both newspapers articles and televisionbroadcasts combined). See Figure 1 for a list of newspaper sources; Figure 2 for a list oftelevision stations; and Figure 3 for a list of counties covered by each newspaper and televisionstation’s designated market area (DMA).Method of analysisThe project staff created a tool to capture each news item’s adherence to critical suggestions asoutlined by the Recommendations. The tool was developed with the help of suicide preventionexperts, researchers and suicide survivor advocates, all of whom were instrumental indeveloping the Recommendations.3Three coders tested the tool on a sample of 20 newspaper articles that were not part of thesample and compared results. Terms were further defined and agreed on. The sample was thengathered and refined, using the exclusion criteria identified above. Coders independentlyanalyzed their own subset of articles. Ten percent of the articles were cross-coded by anotherstaffer to assure inter-rater reliability. Any coding discrepancies were discussed before a finaldecision was reached. Using the definitions that were clarified during the print media analysis, asingle coder analyzed broadcast news items.3The authors would like to thank Ken Norton, Linda Langford, Sc.D., Eileen Zeller, Melissa Allison and DanReidenberg, Psy.D., for their assistance and guidance in developing the adherence tool. Their expertise andfamiliarity with the national Recommendations was invaluable.6 Page
Media AnalysisAreas of AnalysisEleven areas of analysis were developed for all news items; an additional area was included fortelevision broadcast analysis only (see Table 1).Table 1: Media Adherence to Reporting Recommendations Analysis Tool: Areas ofAnalysisArea of AnalysisCoverage typeSuicide preventionresourcesInformation on “Howto Help”Suggestions from theRecommendationsReport on suicide as a publichealth issue.Include up-to-date local ornational resources wherereaders or viewers can findtreatment, information andadvice that promotes helpseeking.Include the provided sidebarthat lists information on“what to do” in the event thereader/viewer knew whoexhibited the warning signs ofsuicide.Information aboutwarning signs andrisk factors forsuicideInclude the provided sidebarthat gives information aboutwarning signs for suicide.Single condition orevent prior to suicideAvoid reports that imply thatsuicide or suicide attempt waspreceded by a single eventsuch as a recent job loss,divorce, or bad grades.Reduce or eliminate reportingLocation of suicideIndicators Measured in theAdherence ToolWhether the news item covers asuicide death or attempt, the topicof suicide (include suicideprevention efforts, new research,etc.) or both.Whether specific resources wereprovided (for example, the nameand phone number to a crisishotline). The tool also enumeratedthe types of resources that wereprovided.Whether news items providesuggestions on how thereader/viewer can help someonewho may be exhibiting warningsigns of suicide or in a suicidalcrisis. The tool also enumerates thetypes of suggestions that areprovided.Whether there was at least onewarning sign or risk factor forsuicide mentioned in the newsitem. These warning signs and riskfactors could have been named bya person interviewed for the story,or by the reporter. Any mention ofevents or conditions thatprecipitated the suicide, whetheror not they were described aswarning signs or risk factors, wereincluded in the analysis. It alsolists the most frequently statedwarning signs and risk factors.Whether or not there was only oneidentified event or conditionpreceding the suicide.Whether exact location of suicide7 Page
Media AnalysisSuicide methodPersons quotedContents of suicidenoteLanguage used todescribe suicideSensational languageabout numbers andrates of suicideVisuals (for televisionbroadcast analysisonly)on details surrounding anindividual’s suicide.or suicide attempt was described.Reduce or eliminate reportingon details surrounding anindividual’s suicide.Seek advice from suicideprevention experts instead ofquoting or interviewing policeor first responders about thecauses of suicide.Do not specify the contents ofa suicide note. Instead, simplystate that a suicide note wasfound, or do not mention asuicide note at all.Use appropriate languagewhen referring to suicide,including “died by suicide,”“completed suicide” or “killedself” as opposed to “successfulsuicide attempt” or “failedattempt.”Do not use sensationalterminology such as“epidemic” or “skyrocketing.”Do not include photos orvideos of the location ormethod of death, or visuals ofmemorials or grieving familyand friends. Instead, itencourages using a school,work or family photo, andshowing hotline logos or localcrisis numbers.Whether explicit descriptions ofthe method or weapon of suicide isdescribed.Types of individuals who arequoted, and whether they are lawenforcement, mental health orsuicide prevention experts, orfamily and community members.Whether or not the contents of asuicide note were revealed.Whether and what appropriate orinappropriate language was usedto describe suicideWhether these types of sensationalterms are used in the news items.Types of visuals used, includinginterviews with neighbors, familyand friends; photos or footage ofsuicide method or location; andon-scene reporting from thesuicide location.FindingsOverall, the analysis determined that the media inconsistently adhered to theRecommendations. While there were some areas of analysis that had very high levels ofadherence, such as not using sensational language, there were other areas that had very lowlevels of adherence, such as providing too much detailed information about suicides, and failingto provide suicide prevention resources. The following pages report on the findings in 12 areas:coverage type, resources, how to help, warning signs and risk factors, attributing suicide to asingle condition, reporting on location, reporting on method, sources of quotes, content ofsuicide notes, language used, reporting on numbers and rates, and visuals.8 Page
Media AnalysisCoverage typeMost news reports covered a suicide death or attempt, with a minority coveringsuicide prevention events, research or prevention programs.Newspaper articlesOf the 161 news articles in the sample, 67% (n 108) covered a suicide or suicide attempt; 16%(n 26) covered the topic of suicide; and 17% (n 27) covered both a specific suicide and thegeneral topic of suicide. A few articles covered suicide “threats” (individuals who declared theirintention to die by suicide but did not harm themselves).Attempts were defined as individuals who made an effort at self-harm or placed themselves inimminent danger, such as outside a bridge barrier. Threats were defined as individuals whowere threatening to kill themselves but were otherwise in a safe location.Articles by covera
reporting on method; sources of quotes; content of suicide notes; language used; reporting on numbers and rates; and visuals. The results of this study show that California newspaper and television coverage of suicide during the last six months of 2011 did not consistently adhere to the Recommendations for Reporting on Suicide.
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Suicide, Samaritans USA , Suicide Awareness Voices of Education , and Yellow Ribbon Suicide Prevention Program. The strategy also reflects the input of family members who have lost loved ones to suicide, those who have attempted suicide, national organizations dedicated to
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